Health insurers overall received a low grade on the American Medical Association’s (AMA) / most recent “National Health Insurer Report Card” (NHIRC). Commercial health insurers have an average claims-processing error rate of 19.3 percent, an increase of two percent compared last year, according to the findings. The increase in overall inaccuracy represents an extra 3.6 million in erroneous claims payments compared to last year, and added an estimated $1.5 billion in unnecessary administrative costs to the health system, AMA says. The AMA estimates that eliminating health insurer claim payment errors would save $17 billion.
The findings from the NHIRC are based on a random sampling of approximately 2.4 million electronic claims for approximately 4 million medical services submitted in February and March of 2011 to Aetna, Anthem Blue Cross Blue Shield, CIGNA, Health Care Service Corp. (HCSC), Humana, The Regence Group, UnitedHealthcare and Medicare. Claims were accumulated from more than 400 physician practices in 80 medical specialties providing care in 42 states.
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